SARASOTA, Fla. – Doctor’s Choice Home Care, Inc. and its former executives, Timothy Beach and Stuart Christensen, have agreed to pay $5.15 million to resolve allegations that the home health agency provided improper financial inducements to referring physicians through sham medical director agreements and bonuses to physicians’ spouses who were Doctor’s Choice employees, the Department of Justice announced today. Doctor’s Choice will pay $3,856,000 to settle these allegations and Beach and Christensen will each pay $647,000. Doctor’s Choice will pay an additional $675,000 to resolve separate allegations that employees pressured clinical personnel to increase the number of home visits for Medicare patients to avoid the Medicare Low Utilization Payment Adjustment that would have decreased the reimbursement Doctor’s Choice received from Medicare in the absence of these unnecessary services.
Doctor’s Choice is a home health agency based in Sarasota, Florida, with branches throughout the state. Timothy Beach and Stuart Christensen founded Doctor’s Choice and formerly served as its top executives.
“The Department of Justice will continue to hold companies and individuals accountable for the payment of illegal remuneration in any form,” said Acting Assistant Attorney General Jeffrey Bossert Clark of the Department of Justice’s Civil Division. “Improper inducements have no place in our federal healthcare system, which relies on healthcare providers making decisions based on the healthcare needs of their patients rather than their personal financial interests.”
“Here in the Middle District of Florida we are committed to ensuring that financial motivations do not corrupt medical decision making, whether in home health care or other areas of medicine,” said U.S. Attorney Chapa Lopez. “Through enforcement of statutes prohibiting illegal kickbacks or improper financial arrangements with referring physicians, this Office will continue to ensure that medical decisions are not compromised.”
“Operating an illegal referral scheme and providing medically unnecessary services places patients at risk and jeopardizes millions of taxpayer dollars,” said Special Agent in Charge of the FBI Tampa Division Michael McPherson. “This settlement highlights the FBI’s commitment to protect the integrity of the federally funded healthcare system.”
The Anti-Kickback Statute prohibits the offering or payment of remuneration to induce or reward referrals for services paid for by federal healthcare programs. The Stark Law forbids certain medical providers, including home health agencies, from submitting claims to Medicare for services provided to patients who were referred by a physician with whom the provider has a prohibited financial relationship, unless that relationship falls within an applicable exception.
This settlement resolves allegations that Doctor’s Choice, Beach, and Christensen violated the Anti-Kickback Statute and the Stark Law by entering into sham medical director agreements with physicians as a means of providing remuneration for referrals, and also violated the Stark Law by providing bonuses to employees based on referrals to Doctor’s Choice by the employees’ physician spouses. In addition, the agreement resolves allegations that Doctor’s Choice provided unnecessary services to Medicare patients in order to increase the number of skilled service visits provided during a home health episode to avoid the Low Utilization Payment Adjustment which otherwise would have decreased Doctor’s Choice Medicare reimbursement. This adjustment is triggered when a home health patient has a treatment episode consisting of less than five skilled service visits and results in the provider receiving a standardized per visit payment rather than the higher payment for a full home health episode.